Pregnancy

Pregnancy is a natural state. It is different for every woman, every time. You never know exactly what you are going to expect, but it does help to be prepared by knowing what changes your body is likely to go through. You can expect to feel all or some of the changes given below.

  • Menstrual periods stop.
  • Morning sickness (nausea and/or vomiting). Even though it is called morning sickness, some women may feel sick at different times of the day.
  • Breasts may swell or be painful to touch
  • Breasts may feel itchy as the skin stretches, and may even develop stretch marks on them
  • Darkening and enlargement of the skin around the nipples (areola)
  • Small glands on the surface of the areolas of the breast called Montgomery’s tubercles become raised bumps
  • Nipples become larger and darker
  • Need to pass urine frequently
  • Feeling tired
  • Constipation
  • Heartburn
  • Mood swings — feel angry, sad, or happy for no reason
  • Craving for food
  • Weight gain
  • Baby starts to move inside the womb (It occurs for the 1st time around 20wks)
  • Stretch marks on the tummy
  • Increase in breast size
  • Constipation and Hemorrhoids
  • Heartburn
  • Slight swelling of the feet, hands, ankles and face
  • Development of a dark line on the skin between your navel (umbilicus) and your pubic area – linea nigra
  • Backaches that can remain throughout pregnancy
  • Milk secretion
  • Muscle cramps, particularly in the legs at night
  • Vaginal discharges
  • Increased movement of the baby inside the womb
  • Protrusion of navel (umbilicus)
  • Backache
  • Shortness of breath
  • Lower abdominal pain
  • Stretch marks
  • Sleep disturbances
  • Leg veins become prominent (Varicose veins)
  • Uterine contractions become more frequent

Solutions for common problems that you may encounter during pregnancy

Wear supportive bras with a little bit of room to grow.

  • Wait for 15 minutes before getting out of bed.
  • Eat small, but more frequent meals
  • Drink some water after meals, and not during meals
  • Avoid spicy and oily foods.
  • Eat a balanced meal with all the nutrients.
  • Don’t do everything alone. Get help from family and friends. Avoid becoming over tired.
  • Get regular exercise (best is to walk).
  • Don’t do all the work at once. Make time to take frequent rest periods.
  • Drink as much as possible. (at least eight to ten large glasses of water or juice).
  • Eat foods high in fiber like fruits, vegetables and green leaves, to prevent or to relieve it.
  • Try to eat small, frequent meals. But do not gobble the whole meal at once. Eat slowly.
  • Avoid hot, spicy goods.
  • Do not drink water in between or with the meals. Eat your food first and then drink the liquids after the meal.
  • When sitting and sleeping try to keep your head elevated.
  • Avoid lying down right after a meal.
  • If it still persists go and talk to your doctor.
  • Keep your head elevated when sleeping (keep an extra pillow).
  • Take a break in between your work. Always rest when you feel out of breath.
  • Avoid rushing to places
  • If symptoms are still not relieved ,visit a healthcare provider.
  • This feeling is common as the bladder holds less urine because of the growth of the baby and its pressure effects on the bladder. Do not worry about this.
  • Continue to drink a lot of water. Don’t reduce just because you are going to the toilet often.
  • If you have burning or pain during urination, please visit your health care provider.
  • Wear cotton underpants which are of light shades.
  • Do not use strong liquid soap or hot water to wash this area.
  • Use only a mild soap not more than twice a day.
  • Always wipe with a dry cloth after washing.
  • Do not touch or use anything to clean your vagina on the inside .
  • Keep the outside area clean with regular baths or showers.
  • Do not use any powders, perfumes, or soaps in your vaginal area.
  • All your under garments after washing should be dried under the sun.
  • If discharge is continuous, has a bad smell, or is yellow or cheesy white and is itchy or burning, talk to your health care provider.
  • Keep legs elevated when sitting and lying down.
  • Try to sleep on your left side.
  • Exercise regularly. Walking is the best
  • Avoid eating foods with a lot of salt (fast foods – French fries)
  • Report any increase in swelling to your health care provider.

How can you know that you are pregnant?

  • The first thing that you will notice is that you have missed your periods. ( All the other symptoms of pregnancy appear later.)
  • Immediately after missing your period, you can do a home urine test or give urine to be checked for urine beta hCG.
  • Pregnancy can also be detected by a trans vaginal scan 2 weeks after missing your period.
 

If you are pregnant what should you do?

You do not need to visit a doctor immediately unless you have any problems.

You should meet the mid wife of your area. Get registered at your village clinic.

Your midwife will give you a pregnancy clinic record card.

You need this to get yourself registered at a government hospital ante natal clinic (ANC).

Depending on the state of the pregnancy your doctor will decide on the subsequent visits.


Eat a balanced, nutritious diet full of vegetables, fruits, pulses, eggs, fish and meat.

Drink a lot of water (ten glasses a day) and fruit juices

You need to take folic acid during the First trimester (1st three months)

You need to start iron and calcium tablets with the folic acid from the fourth month onwards.

You will be given worm treatment during the second trimester.

You can take any of the good food supplementations available in the market.

Do not experiment with foods. Take only foods that you are used to and avoid any food that you are unfamiliar with.

You will see a steady weight gain during the nine months.

This will be monitored at the clinic. If there are any danger signs the health care provider will educate you on this.

Wear light clothes.

Avoid crowded places, as you may be easily exposed to infections.

  • A urine full report (UFR)
  • Haemoglobin level-to detect if you are anaemic (normal Haemoglobin is around 11g/dl, but during pregnancy this may reduce).
  • Blood sugar tests- to determine the sugar levels, generally a post prandial blood sugar test (a blood test done 2 hours following a meal). If there is any abnormality your doctor may suggest additional tests such as a 75g oral glucose tolerance test (OGTT)
  • Blood group
  • VDRL - to check for syphilis
  • Some times a routine ultrasound scan will be done to see how the baby is, to check the placement of the placenta and the fluid level (liquor).

The partner, family and others who associate with the pregnant lady , should make sure that she is stress free and relaxed. They should always help her in her routine house work, talk to her often, ask her about her worries and fears, ask about the pregnancy and about her needs.

Staying stress free helps prevent premature delivary, complications during pregnancy and for the development of a healthy baby. Keep yourself relaxed by visiting places of worship and listening to soft music often.

During the period of pregnancy some women may have increased sexual desire and pleasure, while for some there is no change in sexual feelings or some have a decline in the desire to have sexual intercourse.

You can have sexual intercourse during pregnancy but you may need a different position which is more comfortable for the pregnant woman. Otherwise you can use non coital sexual play as some couples may feel awkward about the protruding uterus and have concerns about the baby.

Some suggested specific positions for sex during pregnancy:

Side-Lying: Front to Back
For the side-lying front to back sex position, have your partner lie behind you and enter you from behind. It may be helpful for you to support your upper leg with a pillow.

Side-Lying: Front to Front
The side-lying front to front position won’t work as well later in pregnancy as your belly grows, but try it early on. The advantages to side-lying front to front include being able to see your partner and not having pressure on your belly. Again, it may help to support your upper leg with a pillow.

Partner on Top
As you progress through pregnancy, having your partner on top of you can become uncomfortable. A little modification to this position can be made is to have your partner on top, with his weight supported by his arms. This way, he is not pushing on your belly, yet you are still able to enjoy this position. Do not stay on your back for long periods of time while pregnant, though, as the extra weight of your baby can put added pressure on your abdomen and eventually your aorta, making you pass out.

Back Entry
For this sex position, you are on your hands and knees with your partner behind you. This position will work well, especially as your pregnancy progresses and your belly gets bigger. There is no extra weight on your belly, and your partner will have room to maneuver. This position can allow deeper penetration, so remind your partner not to thrust too deep.

Partner’s Lap
This sex position is pretty self-explanatory — sit in your partner’s lap. For a little variety, have your partner sit on a chair, and sit facing him.

Woman on Top
One of the advantages of the on-top position during pregnancy is that you can support the weight on your knees, either facing towards or away from your partner, while he is lying down. This position avoids unnecessary weight on your belly; it also allows room for your growing belly.

Walking is the best from of exercise during pregnancy. This also helps you in delivery
Swimming is also another excellent form of exercise. Try to avoid outdoor exercises during days of excessive heat.

It’s also strongly recommended that you call your health care provider immediately if you experience:

  • Bleeding from the vagina
  • Sudden loss of fluid from the vagina
  • Marked absence of movement by the baby once he or she has begun moving
  • More than three contractions in an hour
  • Intense headache
  • Severe vomiting
  • Severe abdominal pain
  • High fever

Anaemia in pregnancy

Anaemia is another problem that may develop during pregnancy and is caused by your increased need for iron. If you are feeling very dizzy, having headaches or shortness of breath and looking pale, you may have anaemia. Your family doctor or midwife will be able to do a quick blood test to tell you if you are anaemic or not.

Good sources of iron include red meat, fish, leafy vegetables, nuts and beans. Also, it may be worth consulting your doctor or midwife about iron supplements.

High blood pressure during pregnancy

Get your blood pressure checked at your routine clinic visits. Also, unusual swelling in the hands, feet and face, caused by changes in circulation, is another reason to see your doctor or midwife. While mild swelling is considered normal, and is usually relieved by lying down to rest, more severe swelling requires prompt medical attention because it may be a sign of high blood pressure during pregnancy.

Diabetes during pregnancy

High blood sugar is a sign of gestational diabetes – but it can only be discovered at your antenatal checks. You may be offered a ‘glucose tolerance test’ at 26-28 weeks, if your doctor is worried that you might be at risk.

A few other side effects of pregnancy

Varicose veins and patchy changes in skin colour are also common during pregnancy. Neither of these signifies a health risk to you or your baby.

Urinary tract infections(UTI), though common during pregnancy are masked, due to pregnancy symptoms. You should seek treatment for a UTI because, in rare instances, infection can contribute to premature delivery.

Above all, remember that physical and emotional changes vary widely from woman to woman, and also between pregnancies. Your body will adapt to being pregnant in its own way, and if you are concerned about anything, just ask your midwife or doctor. The more you understand about your own pregnancy, the more relaxed you will feel – which is better for you, and for your baby!

Lochia - Your uterus will shed its thick lining in a discharge called “lochia.” This is similar to your period, except that the flow is somewhat heavier. The flow will start as bright red, change to reddish-brown, and then to yellowish-white. The flow will last about two to three weeks. If it lasts longer than four weeks, tell your doctor or nurse-midwife.

Genitals - Your vaginal opening was stretched during childbirth, so it may be sore for a few days. if you had stitches, you may continue to have discomfort while your body is healing. A warm bath can help.
Breasts – Your breasts will become filled (engorged) with milk within three to four days after delivery. This can be uncomfortable. If you breast-feed, any discomfort will disappear as soon as a normal feeding pattern is established. If not, ask for help.
Every hospital has a nurse who helps women who are breast-feeding. If you have questions or problems with breast-feeding after you go home, talk to your midwife.

If you aren’t breast-feeding, you can wear a firm support bra and place cold wash clothes to relieve any discomfort. This shouldn’t last more than a day or two.

Bladder and bowels - During delivery, your bladder was squeezed. Therefore, you may have trouble urinating. If so, drink lots of liquids. Things should improve soon. If not, tell your doctor or midwife. Constipation may follow childbirth and can last a week or more. It should clear up after you resume your normal activities. Drinking plenty of liquids, maintaining a healthy diet, with lots of fruits and vegetables, and walking will help.

If you or your baby experience any of the following problems after leaving the hospital, talk to your midwife or baby’s doctor immediately.

Baby ‘s problems

  • shortness of breath
  • Poor feeding
  • Fever
  • Poor flow of urine or crying during urination
  • Umbilical cord becomes red or has a yellow-colored discharge
  • Sleeps more than 20 hours a day and doesn’t wake for feeding
  • forceful vomiting

Mother’s problems

  • Redness or pain in breasts
  • Abdominal pain
  • Burning/pain during urination
  • Redness or yellow discharge from the episiotomy site
  • Redness, swelling or pain in leg
Implants / Depo Injection: If breast feeding, Six weeks after delivery
Intra Uterine Device: Six weeks after delivery
Female Sterilization: Within 48 hours of child birth or any time after 8 weeks of delivery.
Sterilization can also be done just after the LSCS procedure.
Oral contraceptive pill Six months after delivery

What are the advantages?

FOR THE BABY

  1. Due to the anti-infective properties of breast milk, breastfed babies tend to have less or less pronounced symptoms of ear infections, respiratory illnesses, allergies, diarrhea, and vomiting.
  2. Breast milk is designed for baby’s new sensitive digestive system. The amount of proteins and fats in your breast milk is individually tailored to your baby’s needs. Therefore it is easier to digest, less chance of constipation.
  3. Breast milk is constantly changing in its composition to meet the changing needs of the baby. It has the exact combination of protein, fats, vitamins, minerals,
    enzymes, and sugars needed for the growth of the baby.
  4. IQ levels are higher.
  5. The bond between mother and child seems to be enhanced with breastfeeding.

FOR MOTHER

  1. Nursing immediately following delivery causes the uterus to contract lessening the risk of postpartum hemorrhage.
  2. Women who nurse their babies for at least 6 months lessen their chances of pre-menopausal breast cancer.
  3. Osteoporosis and cervical cancer are less common in women who breastfeed.
  4. The return of fertility is delayed with breastfeeding
    .
  5. Many mothers feel a special satisfaction in knowing that they alone are meeting the nutritional needs of their babies.

When should I start?

You should start breast feeding as soon as possible after birth. The best nutrients are supplied from the initial yellow coloured secretion called colostrum. There is no specific time or timetable to breast feed. Give when ever the baby is hungry and asks for milk.

When should I stop?

There is no time limit to stop. You should exclusively breast feed till the child is six months old. During this period you should not even give water or fruit juices.

If I have less breast milk what should I do?

You must remember that the greater the sucking by the baby the greater the secretion of milk. If you still have a problem, seek medical advice. You should feed using both breasts alternately.

  1. A balanced and healthy diet with all the important nutrients is a must for you. (eg. vegetables, fruits, fish, meat, eggs, yoghurt, other milk products and pulses)
  2. Take the basic essentials, your vitamins (folic acid), minerals (iron and calcium tablets, milk), injections (tetanus toxoid) and worm treatment on time
  3. Visit an ante natal clinic (ANC) regularly
  4. Stay relaxed. Stress affects the outcome of the pregnancy and the baby.
  5. Increase the intake of water – at least ten glasses a day. Other fluids like fruit juices are also recommended.
  6. Walking is the best exercise during this period. Any other exercises should be under supervision.
  7. Exclusive breast feeding for at least six months is important.
  8. Stay away from people who smoke. Passive smoking can cause problems for the baby.
  9. Do not use/ inhale or be around any paint, harsh cleaning compounds, bug sprays and pesticides
  10. Monitor your weight gain regularly
  11. Spacing between pregnancies is important for you and for your child’s health. Discuss with your husband and plan for your next child. Get advice from your family doctor or midwife about suitable methods of contraception.
  1. Pregnancy means a new set of responsibilities. Talk to your wife often. Discuss about her expectations and fears. Make her feel you’re there for her.
  2. Your wife is carrying your baby. She is going through many physical and psychological and emotional changes. Be patient and kind to her.
  3. Make her happy and relaxed, since mother’s emotions are felt by the baby.
  4. Get involved with the pregnancy. Make time to visit the doctor with her, go shopping for the baby and for her.
  5. She should eat for her and for the baby. Encourage her to eat healthy food.
  6. Walking is the best exercise. Find time to walk with her.
  7. It is difficult for her to do the routine house work. Give her a helping hand when ever you can.
  8. Smoking harms your baby and your wife. Therefore, avoid smoking.
  9. Excessive use of alcohol may spoil a happy moment. Be mindful about this.
  10. Spacing between children is important for the mother and for the child’s health. Discuss with her and plan your next child. Get advice from your family doctor.